Group therapy

Group therapy, the use of group discussion and other group activities in treatment of psychological disorders. Despite widespread recognition that the groups to which a person belongs may affect his attitudes and behaviour, the traditional medical emphasis on the privacy of the doctor–patient relationship slowed general acceptance of group psychotherapy. Only a few physicians practiced group therapy before World War II. The large numbers of soldiers requiring psychotherapy compelled psychiatrists to try to treat them in groups, and the use of group methods proved so effective that they developed rapidly in the postwar years. The practice of group therapy expanded to clinical and counselling psychologists as well as social workers.

Group therapeutic techniques are as varied as those of individual therapy and similarly tend to stress either alleviation of members’ distress by direct measures or the creation of a group atmosphere conducive to increased self-understanding and personal maturation. Groups of the first type may have any number of members, sometimes up to 50 or more. Some are primarily inspirational in that their chief aim is to raise members’ morale and combat feelings of isolation by cultivating a sense of group belongingness through slogans, rituals, testimonials, and public recognition of members’ progress. Certain of these groups have developed into autonomous movements conducted solely by their members. An outstanding example is Alcoholics Anonymous, organized by chronic alcoholics to help themselves.

The other class of group methods, particularly those utilizing nondirective (client-centred) or psychoanalytic techniques, strives to foster free discussion and uninhibited self-revelation. Most use small face-to-face groups, typically composed of five to eight members with similar problems. Members are helped to self-understanding and more successful behaviour through mutual examination of their reactions to persons in their daily lives, to each other, and to the group leader in an emotionally supportive atmosphere.

Sensitivity training is a technique for improving human interactions in a non-therapeutic setting, and came into vogue (particularly in the United States) in the 1960s and 1970s. Deriving from group therapy methods, it utilizes intensive group discussion and interaction to increase individual awareness of self and others. It has been known under a variety of names, including T-group, encounter group, and human relations or group dynamics training. The methods of such training have been applied to a wide range of social problems (e.g., in business and industry) to enhance trust and communication among individuals and groups throughout an organization.

The idea of treatment of the family as a group (family therapy or counselling) is based on the view that the destructive interrelations of family members may be made more positive by examining their behaviour patterns toward each other. Many family therapists adhere to the principle derived from group process theory that family members adopt various roles; families frequently designate one member to play the martyr role and that individual’s behaviour is correspondingly shaped over time, sometimes to the point of emotional disturbance. Much of the distress of the psychiatric patient is thus viewed to be caused by self-perpetuating and self-defeating ways of relating to intimates. Family therapy is thus an attempt to analyze family roles and readjust them in order to create more balance.

The issues that threaten the stability of the family unit, such as incest, divorce, child abuse, drug or alcohol abuse, questions relating to child-rearing disagreements, finance, social and ethical values, are exposed in the presence of an experienced therapist and openly discussed. Through an understanding of the issues threatening the family and an appreciation of the individual assets of each family member, therapy often leads to an effective resolution of family problems.

The concept of family therapy developed during the early 20th century, largely through the efforts of Austrian psychiatrist Alfred Adler (1870–1937). The offshoot of marital (sometimes known as couple or relationship) therapy derived from the psychotherapy techniques of Swiss psychiatrist Carl Jung (1875–1961). William H. Masters and Virginia E. Johnson based the techniques of their sex therapy on extensive research in human sexual response.

Social, or milieu, therapy for institutionalized patients represents an extension of group therapeutic principles to make the mental hospital a therapeutic community, all aspects of which will help to restore the patients’ mental health. This involves the creation of a positive, supportive atmosphere and a full program of occupational, recreational, and educational activities. It also involves the development of a flexible, democratic social structure in which all members of the treatment staff work as a coordinated team and the patients participate responsibly, to the limits imposed by their disabilities, in all phases of hospital life. See alsopsychodrama.